In a regular and healthy menstrual cycle a female generally has anywhere between 11 to 13 periods/ menstrual cycles each year. In a similar fashion, the average length of the period varies from three days to five days but sometimes can exceed to seven to ten days. A missed period is generally considered as an indicative of pregnancy but it does not always mean that pregnancy has taken place. There are some other conditions in which the notion of no period, not pregnant holds true; i.e. there is absence of periods without pregnancy.
Two Types of Missed Period
In medicine, a missed period is called amenorrhea. Physicians categorize amenorrhea in two major types: primary amenorrhea and secondary amenorrhea.
Primary Amenorrhea
Primary amenorrhea is a condition in which a female older than 15 years of age has never had any period, i.e. her periods have not started yet. The reason can be genetic or due tocertain diseases.
Causes: Lack of presence of uterus from birth, immature development of uterus and genetic abnormalities are some of the common causes of amenorrhea.
Secondary Amenorrhea
A condition in which the female is not having her periods from past three months or more is categorized as secondary amenorrhea.
Causes: The causes of secondary amenorrhea can be various, including polycystic ovaries (PCO), underweight, anxiety and stress, tumor of pituitary gland, etc. It can also mean pregnancy; but it is noteworthy that no period, not pregnant can also be the case.
No Period Not Pregnant, What Can Be the Hidden Causes?
1. Stress
It is common to experience amenorrhea after a stressful event in females. Such a condition is called hypothalamic amenorrhea. Hypothalamus is the part of brain which regulates the reproductive system; it is also responsible for the release of hormones that participate in the pregnancy process.A hormonal disturbance caused by significant stress can result in amenorrhea in most cases.
2. Low Weight
Low body weight or extremely low caloric intake suppresses the activity of hypothalamus; in which case hypothalamus does not release the required female hormone (estrogen)to buildthe uterine lining.Some conditions associated with weight loss such as anorexia nervosa and bulimia nervosa also causes a decline or an increase in estrogen levels, both resulting in abnormal periods or no periods.
3. Thyroid Disorder
Thyroid gland is responsible for the regulation of metabolism, reproduction, energy generation and maintenance of associated systems. If a person is suffering from thyroid problems such as hyperthyroidism or hypothyroidism then a significant effect on the menstrual cycle is also observed in the form of amenorrhea.
4. PCO (Polycystic Ovary)
Polycystic ovary syndrome is characterized by formation of small cysts in the ovary and associated areas. Some of the classic symptoms of PCOS include missed periods (in other words, no periods not pregnant as well), fertility issues, weight loss, etc. The pathophysiology revolves around an imbalance in female reproductive hormones including estrogen, progesterone.
5. Birth Control
Use of birth control agents such as birth controlling pills or use of intrauterine devices can cause loss of periods as a side effect, which is generally harmless. Low dose pills are often associated with disturbed menstrual pattern and sometimes, lack of menses.
6. Premature Menopause
Symptoms of premature menopause can include hot flushes, vaginal dryness, night sweats, etc. when the female is under 40 years of age. Also termed as premature ovarian failure, no periods without being pregnant can also be an indication of this condition, and just consult your gynecologist timely.
7. Excessive Exercise
Women who perform more physical activities than usual such as female athletes, ballet dancers and gymnasts, etc. are at a greater risk of experience the condition of no period not pregnant. Over stressing the body through excessive exercise can cause hormonal disruptions. Some of the symptoms indicating excessive exercise can include decline in physical performance and rapid weight loss. Besides, performing work with illnesses and injuries forcefully will also lead to missed period.
8. Breastfeeding
Prolactin, a female hormone, is secreted from mammary glands to produce milk for breastfeeding, which will suppress the process of ovulation. That's why breastfeeding women report the situation of no period without being pregnant. However, it causes no concern, and the periods generally return after six to eight when a female wean off. Consult your doctor if the periods don't come back after that.
9. Chronic Disease
Any chronic conditions can affect your whole wellbeing. Without proper treatment, they will place a stress on the body, and lead to issues of no period not pregnant. For example, celiac disease is characterized by gluten intolerance. Based on clinical data, untreated celiac disease is very frequently observed in women with amenorrhea.
10. Medications
Use of certain medications such as birth control pills (hormonal contraceptives) is some of the common reasons for no period but not pregnant. Sometimes, you can observe a withdrawal bleeding (actually a fake period) to make the body compatible with the use of pills. Excessive dose may sometimes result in light spottingor no period.
11. Pituitary Tumors
Pituitary gland is responsible for producing multiple hormones which performs regulatory functions. A tumor in pituitary gland (usually non-cancerous) that results in excessively high levels of estrogen hormone can interfere with normal menstrual cycle. In severe cases surgery for removal of this tumor is required.
12. Schedule Changes
Changing in normal schedule such as changing shifts of sleep cycle which normally happens during travelling or long flights is common with no periods.
Should I Be Concerned?
From the above mentioned causes of no period not pregnant, as for the lifestyle issues, just try to avoid them and route your life with healthy habits. Yet, medical conditions should be treated timely and properly. Consultation with the physician is necessary if you observe the following conditions:
- There is a constant pain in lower belly
- Two consecutive periods are missed with no significant reason
- Two periods missed while using birth controlling pills without skipping pills
- The periods have not started until 16 years old
- No sign of pubic hair or not developed breasts is observed by the age of 14
No Period But Not Pregnant, What Can I Do?
"I have no periods not pregnant either! So when will the periods come back?" It is one of the most frequently asked questions, and the answer relies on the cause. You need to first identify the exact causes and then adapt specific treatment methods to regain the normal menstrual flow.
- For PCOS, hormonal therapy is indicated.
- Weight is advised to be gained in case the female has a very low weight. Maintain healthy diet and eat fresh so that the periods will come normal.
- Sometimes physicians recommend to just waiting for a while in case the periods appear on their own.
- If periods are missed after pregnancy then they will come back once the breastfeeding is stopped or weaned off.
- Try eliminating stuff which can apply any kind of stress to the body such as alcohol intake, use of drugs, smoking, etc.
- In severe conditions such as ovarian failure, it is not possible to restore the normal physiology of the system.